The Effect of Amblyopia on Fine Motor Skills in Children

School of Optometry and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Investigative Ophthalmology & Visual Science (Impact Factor: 3.4). 03/2008; 49(2):594-603. DOI: 10.1167/iovs.07-0869
Source: PubMed


In an investigation of the functional impact of amblyopia in children, the fine motor skills of amblyopes and age-matched control subjects were compared. The influence of visual factors that might predict any decrement in fine motor skills was also explored.
Vision and fine motor skills were tested in a group of children (n = 82; mean age, 8.2 +/- 1.7 [SD] years) with amblyopia of different causes (infantile esotropia, n = 17; acquired strabismus, n = 28; anisometropia, n = 15; mixed, n = 13; and deprivation n = 9), and age-matched control children (n = 37; age 8.3 +/- 1.3 years). Visual motor control (VMC) and upper limb speed and dexterity (ULSD) items of the Bruininks-Oseretsky Test of Motor Proficiency were assessed, and logMAR visual acuity (VA) and Randot stereopsis were measured. Multiple regression models were used to identify the visual determinants of fine motor skills performance.
Amblyopes performed significantly poorer than control subjects on 9 of 16 fine motor skills subitems and for the overall age-standardized scores for both VMC and ULSD items (P < 0.05). The effects were most evident on timed tasks. The etiology of amblyopia and level of binocular function significantly affected fine motor skill performance on both items; however, when examined in a multiple regression model that took into account the intercorrelation between visual characteristics, poorer fine motor skills performance was associated with strabismus (F(1,75) = 5.428; P = 0.022), but not with the level of binocular function, refractive error, or visual acuity in either eye.
Fine motor skills were reduced in children with amblyopia, particularly those with strabismus, compared with control subjects. The deficits in motor performance were greatest on manual dexterity tasks requiring speed and accuracy.

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Available from: Ann L. Webber
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    • "However, far more defects have been found in patients with amblyopia. In addition to deficits in primary visual detection or discrimination (Eggers and Blakemore, 1978; Greenwood et al., 2012; McKee et al., 2003) or mid-level visual tasks involving local feature and contour integration (Chandna et al., 2001; Hess et al., 2001) and motion perception (Knox et al., 2013; Simmers et al., 2003, 2005), individuals with amblyopia also show higher-level impairments in visuomotor and visually guided movements (Niechwiej-Szwedo et al., 2010, 2011, 2012a, 2012b; Secen et al., 2011; Suttle et al., 2011; Webber et al., 2008), visual decision-marking (Farzin and Norcia, 2011), visual attention (Popple and Levi, 2008; Thiel and Sireteanu, 2009) and number processing (Mohr et al., 2010). As such, the underlying neural mechanism of amblyopia may be more comprehensive than what has previously been reported, and these mechanisms most likely involve additional neural connections and functional systems across the brain. "
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